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How the wider NHS works

Details on where the trust fits in with the wider NHS

The NHS is a complex organisation and we are one part of the service that provides healthcare to local people.

In this section we try to provide some basic information so you can understand how the services work and link together and where Warrington and Halton Hospitals NHS Foundation Trust fits into the wider system.

In simple terms, the NHS is divided into a series of organisations who work closely together:

  • NHS England monitor the performance of the NHS nationally and support commissioning (planning and paying) of services locally
  • Clinical commissioning groups (CCGs) are run by local general practitioners (GPs) and healthcare professionals who run primary care services (such as your GP service) and assess local health needs. They hold the budget for the majority of health care locally and then commission health services to meet those needs – for our trust, the two main CCGs who we work with are Warrington Clinical Commissioning Group and Halton Clinical Commissioning Group
  • NHS acute or foundation trusts like ours provide the hospital, out-patient and other services commissioned by CCGs to meet local population needs
  • Ambulance trusts provide services responding to 999 calls and transporting patients – our local ambulance trust is North West Ambulance Service NHS Trust
  • Mental health trusts provide specialist care for people with complex and severe mental health problems – our local mental health trust is North West Boroughs Healthcare NHS Foundation Trust
  • Community trusts co-ordinate community health services for individual users – our local community trust is Bridgewater Community Healthcare NHS Foundation Trust and local authoritiessuch as Warrington Borough Council and Halton Borough Council provide social care services in the community and manage public health. Local authorities also run health and wellbeing boards that ensure joined up working across health and social care.

This is a simple list of organisations locally. We work to provide care to patients from surrounding areas as well so link in with many other CCGs and other trusts and local authorities.

We also work closely with regulators of the health services such as Monitor and the Care Quality Commission and a range of local groups such as HealthWatch - the independent consumer champion for health and social care services.

  • There are almost 250 hospital, mental health and ambulance trusts in England and over 160 CCGs
  • NHS hospitals employ the largest number of people in the NHS, both as clinical staff in hospitals and across a wide range of support functions. Most hospitals are one of the biggest employers in their local area
  • Hospital trusts are dependent on CCGs buying services such as elective surgery, outpatient visits and other treatments from them. Hospital trusts can also be commissioned to run community services such as district nursing and health promotion. Alternatively, CCGs may commission other providers, such as social enterprises, private companies or local charities, to run these services
  • Around 90 percent of our income comes from CCGs to provide our services.

The Sustainability and Transformation Plan (STP) for Cheshire and Merseyside, sets out how the health and care system can remain fit for the future and respond successfully to the growing demands that are being placed on it, alongside ambitious ideas to improve the health of people living and working in the region.

The document sets out a shared core purpose to ensure that the people of Merseyside and Cheshire become healthier than they are now and can continue to have access to safe, good quality and sustainable services.

The plan represents the thoughts and ambitions of more than 30 different organisations serving a population of over 2.5 million people. The next stage will refine the ideas further, through engagement with local communities, the NHS workforce and other stakeholders such as local councils and the voluntary sector.

Follow our social channels for further updates and look out for information about opportunities to find out more and get involved.

Cheshire and Merseyside Sustainability and Transformation Plan


There are a range of useful sources of information about the NHS and how it works. Ones that we think are particularly useful are: